Letter of Authorizzation

hereby authorize the He

ealth Authoritty of Abu Dhabi
D
or Data
aFlow FZ LL
LC, its autho
orized affiliattes, agents
n
nd subsidiarie
es, acting on its behalf to verify information, docum
mentation and back ground
d verification presented
on
n my applicatiion form including but not limiting to edu
ucation, emplo
oyment and liccenses.

th
he Health Auth
hority of Abu Dhabi or Data
aFlow FZ LLC
C, its authorizzed affiliates, a
agents and su
ubsidiaries.

Th
his informatio
on / documentation may co
ontain but is not limited to
o grades, dattes of attenda
ance, grade p
point average
e,
de
egree / diplom
ma certificatio
on, employme
ent title, emp
ployment tenu
ure, license a
attained, statu
us of the lice
ense, place of
o
issue and any
y other inform
mation deeme
ed necessary
y to conduct the verification of the information / d
documentation
n
prrovided.

se all person
ns or entities requesting or supplying ssuch informattion from anyy liability arisiing from such
h
I hereby releas
y of this auth
horization be accepted witth the same authority as the original. I
disclosure. I am willing thatt a photocopy
urther understtand and ack
knowledge tha
at this Inform
mation Releasse Form will remain valid for a period of two years
s
fu
fo
ollowing its completion.

Pe
ersonal Deta
ails:
(in
n BLOCK lette
ers)

Fu
ull Name

:
(La
ast / Surname))

(Fi rst Name)

(Middle Name)

Pa
assport / Identitty Card Numbe
er:

Signature

Date (d
dd/mm/yyyy)